| National Provider Identifier [NPI]: | 1609852672 |
| Last Name Of The Provider | BRANTLEY |
| First Name Of The Provider | KEITH |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 751 FOREST AVE |
| Street Address 2 Of The Provider | STE 301 |
| City Of The Provider | ZANESVILLE |
| Zip Code Of The Provider | 437012868 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 85 |
| Number Of Services | 4767 |
| Number Of Medicare Beneficiaries | 1630 |
| Total Submitted Charge Amount | 819128.69 |
| Total Medicare Allowed Amount | 378547.85 |
| Total Medicare Payment Amount | 280881.38 |
| Total Medicare Standardized Payment Amount | 289982.48 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 87 |
| Number Of Medicare Beneficiaries With Drug Services | 19 |
| Total Drug Submitted ChargeAmount | 6458.48 |
| Total Drug Medicare AllowedAmount | 3618.71 |
| Total Drug Medicare PaymentAmount | 2837.1 |
| Total Drug Medicare Standardized Payment Amount | 2837.1 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 83 |
| Number Of Medical Services | 4680 |
| Number Of Medicare Beneficiaries With Medical Services | 1630 |
| Total Medical Submitted Charge Amount | 812670.21 |
| Total Medical Medicare Allowed Amount | 374929.14 |
| Total Medical Medicare Payment Amount | 278044.28 |
| Total Medical Medicare Standardized Payment Amount | 287145.38 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 265 |
| Number Of Beneficiaries Age 65 to 74 | 548 |
| Number Of Beneficiaries Age 75 to 84 | 542 |
| Number Of Beneficiaries Age Greater 84 | 275 |
| Number Of Female Beneficiaries | 879 |
| Number Of Male Beneficiaries | 751 |
| Number Of Non Hispanic White Beneficiaries | 1528 |
| Number Of Black or African American Beneficiaries | 76 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1158 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 472 |
| Percent Of With Atrial Fibrillation | 30 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 47 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 71 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.6833 |